Objective. To analyze the different effects of Continuous Lumbar Drainage of fluid and lumbar puncture drainage for aneurysmal subarachnoid hemorrhage (SAH) after intracranial aneurysm clipping. Method. Seventy-five patients with aneurysmal SAH who underwent aneurysm clipping were retrospectively analyzed and were divided into two groups according to the different postoperative drainage methods. The lumbar spine group received lumbar puncture drainage, and the lumbar cistern group received lumbar pool continuous drainage to compare the efficacy. Result. The time to normalize intracranial pressure and headache relief after drainage treatment in the lumbar cistern group was shorter than that in the lumbar spine group. The GOS score was higher than that in the lumbar spine group, and the cerebral artery flow velocity and NIHSS score were significantly lower than those in the lumbar spine group ( P < 0.05 ). The total effective rate of drainage treatment was 76.32% in the lumbar cistern group, which was higher than that in the lumbar spine group (54.05%) ( P < 0.05 ). The total complication rate was 18.42% in the lumbar cistern group, which was lower than that in the lumbar spine group (40.54%) ( P < 0.05 ). Conclusion. Continuous Lumbar Drainage of fluid after intracranial aneurysm clipping for aneurysmal SAH can control symptoms more rapidly, reduce neurological deficits, and improve prognosis than lumbar puncture. Also, the drainage is safer and more widely used.

Objectives: We investigated the effects of autologous vein transplant on bile duct injury repair, through observation of the hepatic and biliary system tissue morphology changes and animal survival after bile duct injury repair. Materials and Methods: Rabbits were equally divided into groups. Group A had cholecystectomy and common bile duct resection (length of 0.5 cm), transplant of an autologous vein (length of 0.5 cm), and stent implant. Group B had cholecystectomy and common bile duct resection (length of 1.0 cm), transplant of an autologous vein (length of 1.0 cm), and stent implant. The third group (group C) had cholecystectomy only. Results: Two rabbits died in group A and group B; all experimental animals from group C survived. Regarding liver biochemical indexes at preoperative week 1, at postoperative month 1, and at postoperative month 3, we found no significant differences (paired t test, P > .05). Liver biochemical indexes between groups were also not significantly different (P > .05). At month 3, postoperative liver pathology of experimental animals showed no significant changes and no cholestasis; biliary epithelial cells were seen in the transplant vascular. Conclusions: We conclude that autologous vein graft can effectively repair bile duct injury for a short coloboma. Key words: Bile duct resection, Biliary repair, Cholecystectomy, Experimental study IntroductionBile duct injury (BDI) is one of the most serious complications in biliary tract surgery, which can be indicated after trauma, for biliary neoplasms, and for cancer that has infiltrated into the bile duct. Severe bile duct injury can lead to repeated biliary infection, biliary stricture, biliary cirrhosis, liver failure, and even death. Laparoscopic cholecystectomy (LC) has become the standard surgical treatment for gallstone disease and is one of the most routinely performed abdominal procedures by general surgeons. Despite the known benefits of a mini-invasive surgical approach, treatment and prevention of BDI are still challenging because, in most cases, BDI represents a serious problem and can have late complications. 1 The incidence of BDI seems to have decreased compared with earlier periods. 2 However, several studies have shown a persistently higher rate and complexity of BDI when LC is performed compared with the open procedure (0.3% to 0.6% vs 0.2%). [3][4][5][6] However, the incidence of BDI in the LC were reported to be different in some retrospective studies. [7][8][9] To date, the best management strategy in terms of timing of repair remains controversial. [10][11][12] Most authors agree that intraoperative recognition of BDI with immediate repair by specialized hepatopancreatobiliary surgeons offers the best results. 13 In recent years, different materials and methods have been reported for BDI repair, with each having different effects. Our study investigated autologous vein graft for repair of BDI using an animal model. Materials and MethodsThis study was carried out in strict accordance with the recommendations...

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Background: Treatment of complications after esophageal stent placement and methods for removal of stents need to be improved. The purpose of this study was to evaluate the safety and efficacy of stent-in-stent (SIS) removal of esophageal stent under fluoroscopy.Methods: This study retrospectively analyzed the clinical data of consecutive patients undergoing esophageal stent removal by SIS under fluoroscopy. Under awake condition, local anesthesia, and fluoroscopic monitoring, a second esophageal stent was placed in the first esophageal stent. Four weeks later, both esophageal stents were removed by the SIS technique under fluoroscopy.Results: A total of 12 patients were treated by the SIS removal technique. In 10 patients, the first esophageal stent was easily removed by the SIS method; in the other 2 patients, stent fracture occurred, and some residual nitinol wire had to be removed endoscopically. No serious complications occurred in any patient.Conclusions: The SIS removal technique appears to be a safe and effective method for removal of embedded esophageal metallic stents.